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Abstract
Case Report
A case of exacerbation of autoimmune hemolytic anemia after COVID-19 vaccination during immune checkpoint inhibitor therapy in a patient with large-cell neuroendocrine carcinoma
Kazuki Jinno Shinsuke Shiotsu* Shoki Matsumoto Syunya Tanaka Tatsuya Yuba Chieko Takumi
Department of Respiratory Medicine, Japanese Red Cross Society Kyoto Daiichi Hospital
*Present address: Department of Respiratory Medicine, Japanese Red Cross Society Kyoto Daini Hospital
ABSTRACT
A 50-year-old man diagnosed with primary pulmonary large-cell neuroendocrine carcinoma complicated by autoimmune hemolytic anemia received a COVID-19 vaccine while undergoing combination immunotherapy. Two weeks after vaccination, he was admitted due to progressing anemia and swelling of the left upper limb. The direct Coombs test was positive, and there was an upward trend in indirect bilirubin, lactate dehydrogenase, and reticulocyte count, leading to the diagnosis of a recurrence of autoimmune hemolytic anemia. Prompt improvement in anemia was observed with an increase in steroid dosage. It is necessary to be cautious about exacerbation of autoimmune diseases and paraneoplastic syndrome after COVID-19 vaccination during immune checkpoint inhibitor therapy.
KEYWORDS
Autoimmune hemolytic anemia (AIHA) Large-cell neuroendocrine carcinoma (LCNEC) Immune checkpoint inhibitor (ICI) Coronavirus disease 2019 (COVID-19) Vaccination
Received 5 Dec 2023 ／ Accepted 31 Jan 2024
AJRS, 13(3): 101-105, 2024
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